Abstract
BACKGROUND CONTEXT: Revision indications on total disc replacement (TDR) may include implant loosening, malposition, displacement, early wear, and infection. Each indication will likely require different preoperative planning, testing, and strategies. Preoperative planning is the first and most important step in performing a revision of TDR. An organized approach reduces operative time, minimizes risks, decreases stress, and increases the success rate. Primary revision strategies for failed total disc arthroplasty can be planned as a posterior fusion, leaving the total disc replacement device in place, or by way of anterior removal with subsequent anterior fusion or revision replacement of the prosthesis. An anterior revision approach carries significant risk and should only be performed by surgeons experienced in anterior lumbar surgery.
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